While we have heard of bulimia, the idea of ‘exercise bulimia’ is relatively new.

With bulimia nervosa, a person feels the need to purge following food consumption.

Exercise bulimia, however, means engaging in excessive exercise to eliminate calories from the body — which causes the person to be at the gym for hours on end. It is, as Mr O’Neil describes, “compulsive exercise as a form of purging”.

'Today, I will run and lift weights, despite instructions from my doctors to take it easy this year as I deal with a back injury.'Source:istock

“Exercise bulimia manifests itself in different ways — from excessive exercise to compensate for calories consumed, to starving oneself but continuing to exercise, to an all-consuming obsession with exercise to the point of serious self-harm, as in my case at the moment,” he writes.

“I am by no means the picture of health or even particularly muscular-looking — not for someone who exercises this much, and definitely not compared to most of the men I see at my gym.”

Or maybe he is, but the disorder has given him doesn’t “correspond with reality”.

“I see a fat piece of sh*t, and then I think to myself that it’s time to punish my body for letting me down.”

But Mr O’Neil’s motivation is to “earn the next day’s meal”. His relationship with exercise is a form of punishment, and only concludes when he feels like he’s earnt it. The disorder is “as destructive as any other type of addiction”.

“Once I feel I have earned it, I will eat a large meal, thereby resetting the cycle of guilt, and begin the process all over again tomorrow,” he writes.

Once upon a time, Mr O’Neil said he thought his exercise regimen was “admirable, a point of pride”.

But now, as he explains, his exercise obsession is far more than just an active lifestyle.

“I will run until my knees ache and my back stiffens,” he writes.

“I will manage the ensuing pain with too much Advil. Being skinny, even with back pain, feels a lot better than being chubby.”